To be or not to be on ECMO: can survival prediction models solve the question?Authors: Rozencwajg S, Fraser J, Montero S, Combes A, Schmidt M
Abstract
Over the past decade, there has been growing interest in extracorporeal membrane oxygenation (ECMO) as a rescue therapy for patients with severe acute respiratory distress syndrome (ARDS) and cardiogenic shock. Although survival of ECMO-treated patients has improved recently, the incidence of ECMO-related complications such as bleeding and nosocomial infections remains unacceptably high. In addition, patients often experience long-term physiological and psychological sequelae. Hence, identifying patients who will most likely benefit from ECMO ...Source: Critical Care and Resuscitation - November 2, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Acquired von Willebrand syndrome in respiratory extracorporeal life support: a systematic review of the literature.CONCLUSION: The prevalence of AvWF among patients on VV ECMO or ECCO2R is high, but only a limited number of studies are reported in the literature. AvWS testing should be performed, including vWF multimer analysis, vWF activity and vWF antigen concentration. The extent to which vWF contributes to bleeding during ECMO, or how much changes in ECMO management can influence high molecular weight vWF multimer levels, cannot be answered from the currently available evidence and there remains a need for future studies.
PMID: 29084501 [PubMed - in process] (Source: Critical Care and Resuscitation)Source: Critical Care and Resuscitation - November 2, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

A scoping review of use of wearable devices to evaluate outcomes in survivors of critical illness.Authors: Gluck S, Chapple LS, Chapman MJ, Iwashyna TJ, Deane AM
Abstract
OBJECTIVE: Wearable devices using new technology may be a cost-effective method to assess functional outcomes in survivors of critical illness. Our primary objective was to review the extent to which wearable devices such as smartphones, pedometers, accelerometers and global positioning systems have been used to evaluate outcomes in survivors of an intensive care unit admission.
DESIGN: We included studies of patients surviving an ICU admission and which measured outcomes using wearable devices. We performed a scoping review of studies fou...Source: Critical Care and Resuscitation - September 6, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Critical care management of aneurysmal subarachnoid haemorrhage in Australia and New Zealand: what are we doing, and where to from here?Authors: Udy AA, Schweikert S, Anstey J, Anstey M, Cohen J, Flower O, Saxby E, Poll AV, Delaney A
Abstract
Patients with an aneurysmal subarachnoid haemorrhage (SAH) frequently require admission to the intensive care unit. There, a variety of therapeutic strategies are initiated, in addition to definitive procedures aimed at securing the aneurysm. Despite a substantial investment in caring for these patients, outcomes for this group remain poor. Although the severity of the initial bleed is crucial in this context, many patients undergo further deterioration in the ICU. Delayed cerebral ischaemia is a significant c...Source: Critical Care and Resuscitation - June 28, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Considerations for co-enrolment in randomised controlled effectiveness trials in critical care: the SPICE-8 co-enrolment guidelines.Authors: Reade MC, Bass F, Howe B, Seppelt I, Shehabi Y
Abstract
The Australian and New Zealand Intensive Care Society Clinical Trials Group and other investigator-led trials groups in critical care publish policies and guidelines outlining the rationale for considering co-enrolment in large, randomised controlled trials in intensive care medicine. However, none present a checklist of criteria by which a request for permission to co-enrol in an existing trial can be assessed. Consequently, such requests tend to be made and assessed on an ad hoc basis. Based on our experience in the SPICE III randomised controlled t...Source: Critical Care and Resuscitation - June 28, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

New sepsis definition changes incidence of sepsis in the intensive care unit.CONCLUSIONS: Adopting the SOFA criteria will increase the apparent incidence of sepsis in patients admitted to the ICU with infective conditions without affecting the mortality rate. Prospective evaluation of the effect of adopting the new definition of sepsis is required.
PMID: 28215126 [PubMed - in process] (Source: Critical Care and Resuscitation)Source: Critical Care and Resuscitation - February 23, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Characteristics and outcomes of critically ill patients with drug overdose in Australia and New Zealand.Authors: Cioccari L, Luethi N, Bailey M, Pilcher D, Bellomo R
Abstract
OBJECTIVE: The epidemiology of patients admitted to the intensive care unit after a drug overdose (OD) is poorly defined. We aimed to study the incidence, characteristics and outcomes of patients admitted to the ICU because of OD in Australia and New Zealand.
DESIGN, SETTING AND PATIENTS: Retrospective study of data from the Australian and New Zealand Intensive Care Society Adult Patient Database, including all patients admitted to an ICU with OD from 2005 to 2013.
RESULTS: Overall, of 883 618 patients treated in the ICU during the study...Source: Critical Care and Resuscitation - February 23, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Use of imaging studies for determination of brain death in South Australian intensive care units.Authors: Sampson BG, Datson LD, Bihari S
Abstract
OBJECTIVES: To describe the use of imaging studies (four-vessel angiography or radionuclide scan) for brain death determination in South Australian intensive care units, and to determine the rates of adherence with The ANZICS statement on death and organ donation of the Australian and New Zealand Intensive Care Society (ANZICS).
DESIGN, PATIENTS AND SETTING: Retrospective case-note review of 190 South Australian adult patients (≥ 18 years) who were brain dead and were organ donors (actual and intended), from 1 January 2008 to 31 December 2014.
MAIN OUTCOM...Source: Critical Care and Resuscitation - February 23, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research

Rapid response team diagnoses: frequencies and related hospital mortality.Authors: Smith RJ, Santamaria JD, Faraone EE, Holmes JA, Reid DA
Abstract
OBJECTIVES: To describe the frequency and hospital mortality of problems (diagnoses) encountered by a rapid response team (RRT), and to identify the most common diagnoses for RRT triggers and for treating units.
DESIGN: For each RRT event in 2015 at a tertiary hospital for adults, we chose the diagnosis that best explained the RRT event from a pre-defined list after reviewing relevant test results and clinical notes.
RESULTS: There were 937 RRT events during 700 admissions and there were 58 different RRT diagnoses in 11 diagnosis grou...Source: Critical Care and Resuscitation - February 23, 2017 Category: Intensive Care Tags: Crit Care Resusc Source Type: research